Inspection on 21/05/07 for Ludlow Lodge Care Centre

This inspection was carried out on 21st May 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Ludlow Lodge Care Centre 18/08/06

Ludlow Lodge Care Centre 02/12/05

Ludlow Lodge Care Centre 30/06/05

Ludlow Lodge Care Centre 21/02/05

Ludlow Lodge Care Centre 03/06/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Ludlow Lodge Care Centre Ludlow Lodge Alcester Road Wallington Surrey SM6 8BB Lead Inspector David Pennells Key Unannounced Inspection 21st May 2007 10:00a 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 Ludlow Lodge Care Centre DS0000038481.V340375.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. Ludlow Lodge Care Centre DS0000038481.V340375.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ludlow Lodge Care Centre Address Ludlow Lodge Alcester Road Wallington Surrey SM6 8BB 020 8669 7260 020 8773 1215 rita.collier@sutton.gov.uk 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) London Borough of Sutton Rita Anne Collier Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Ludlow Lodge Care Centre DS0000038481.V340375.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide personal care (excluding nursing) and accommodation to service users of both sexes whose primary care needs on admission to the home are within the following category:Old age not falling within any other category (Category OP) (no more than 40 persons) Intermediate Care Beds can accommodate service users who are 50 years of age and over. (no more than 2 persons) The maximum number of service users who can be accommodated is 40 18th August 2006 2. 3. Date of last inspection Brief Description of the Service: Ludlow Lodge is a substantial residential home now providing long-term care and accommodation to a diminishing number of older, physically frail people and also providing an Intermediate Care service on the first floor. The home is owned, managed and maintained by the London Borough of Sutton’s Community Services Department. The home is located off a busy main arterial road linking Croydon and Sutton to Wallington - the town centre of which is close by - providing good transport links and community resources. The home is laid out on 2 floors, the upper floor being accessible by passenger lift. All bedrooms are single occupancy; some larger bedrooms now make attractive, accessible, single rooms. The home is split into smaller living units, providing a distinct ‘group living’ model of care, each having a member of staff allocated, per shift, to support service users - with additional ‘floating’ staff. Each unit has its own lounge, dining area and bathing and toilet facilities; there is also a small kitchen in each unit, where breakfasts and snack meals are freshly prepared. The home has a central kitchen, where the main meals are prepared and distributed to the units and also to the attached day care centre. Current long-term service users at Ludlow Lodge have been supported to handle the changes experienced with the Intermediate care service ‘moving in’ on the first floor, whilst the longer-term community is situated on the ground floor. Ludlow Lodge Care Centre DS0000038481.V340375.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. We inspected the service over a daylong visit, arriving mid-morning and staying until late afternoon. During this time there was an opportunity to meet with the manager, speak to staff, to visit those who lived in the service with the chance to discuss how they found the experience of living there. There was also an opportunity to review documentation and the premises, and safety standards within the home. This is the ‘first’ inspection of the service since Ludlow Lodge and Bawtree House (a separate home providing Intermediate care services in West Sutton) had ‘joined together’ under one roof. We rated both services individually as ‘good’ to ‘excellent’ services and with the manager of Bawtree House taking on the overarching managership of this ‘new’ service, there was every reason which was borne out by this visit - for optimism for the future. The previous manager of Ludlow Lodge took the opportunity to retire from his position. This significant move took place as part of the development plan of Older People’s Care Services in the London Borough of Sutton - the very long-term future of the home beyond 2009 is yet to be confirmed. The manager had provided us with a pre-inspection questionnaire beforehand, providing current information about the service, and surveys were also received back from relatives and professionals who visit the service. This report is also based on any other information received about the service since the last inspection visit and report. What the service does well: We found that the service provided to those who live at the home on a longterm basis is really appreciated. All of the people living on the ground floor had decided to stay at the home even though a major change - the introduction of the Intermediate Care service - had, in some ways, radically changed the way in which the service was run - with some residents even having to change rooms and move down to the ground floor. Those talked to said that the change had been handled well and they were getting used to the new staff and way in which the home was being run. We found that those using the Intermediate Care service were very happy with the service they received - the ethos of the first floor being to encourage rehabilitation to the point of people leaving Ludlow Lodge and returning home. This service is ‘unique’ in Sutton in that the majority of those using the service are desperately keen to try to leave the place – and return to their own homes. Ludlow Lodge Care Centre DS0000038481.V340375.R01.S.doc Version 5.2 Page 6 We found the general feeling in the home to be one of life and activity, and genuine (and realistic) encouragement between service users to ‘do well’ with their rehabilitation programmes, to ‘get well enough’ / ‘recover’ to return back under their own roofs / in their own beds. Care staff members, also, have the same positive attitude towards the success of a service user’s achievement – feeling sad that friendships are breaking at the point of discharge - but feeling positive about what the home has been able to achieve. We found that the encouraging and affirming ethos of the home, stemming from the management downwards, encourages this positive approach to the service provided. What has improved since the last inspection? What they could do better: We took into account the fact that at the point of the inspection visit the two services had only recently integrated. We noted the positive response from those using the service and those who visited relatives at the home, and also noted the cooperative way in which the two teams were clearly coming together to work as one unit - not an easy task. Alongside this, some paperwork and focuses were still developing - but these minor omissions were not detrimental to the service outcome, nor were they being deliberately ignored. We had confidence that the whole service would be fully operative to its maximum in a short period of time. One requirement only - is brought forward from the last inspection - and requires that the registered provider regularly produces reports of the visits that are actually made under Regulation 26 to check the conduct of the home, and that these reports are sent to the Commission. This would enable us to assess evidence that sufficient concern is being given to dealing with the ongoing integration of the two services at Ludlow Lodge. A sole recommendation asks that the quality of decoration and furnishings / furniture be reassessed on the ground floor to ensure that sufficient attention is paid to the ‘established’ part of the home, maintaining a sense of quality especially in the kitchenette areas. Ludlow Lodge Care Centre DS0000038481.V340375.R01.S.doc Version 5.2 Page 7 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. Ludlow Lodge Care Centre DS0000038481.V340375.R01.S.doc Version 5.2 Page 8 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 Ludlow Lodge Care Centre DS0000038481.V340375.R01.S.doc Version 5.2 Page 9 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): 3 & 6. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home’s process for assessing prospective service users - and subsequent decisions about their future - takes into account the factors that are identified through the detailed exploration of needs, both written and spoken. Staff members clearly have the collective skills and experience to deliver a service to a good standard for dependent ‘older people’ living at the home. Service users assessed for intermediate care services are positively helped and encouraged to meet their planned goals and to maximise their independence quickly, thus facilitating their speedy return home. Services are based on professional best practice and the home’s ethos is one of keeping abreast of current thinking with regard to supporting people to stay at home for as long as is reasonably possible and practicable. Ludlow Lodge Care Centre DS0000038481.V340375.R01.S.doc Version 5.2 Page 10 EVIDENCE: We found that no new permanent admissions have been made since the new registration of the home, however some service users had arrived previously on ‘limited term’ contracts, in the full knowledge of the fact that the future of the home remains under review. We found that all temporary placements at the home had been furnished with full assessment documents – this enabling the home, along with the familiarisation documents, to ensure that a plan of care had been devised for the point of admission. We saw a familiarisation / ‘Social History’ document which is used for staff to get to know service users better, especially in the early days of their stay; it is designed to collect the ‘soft’ or ‘informal’ information intended for staff - who are expected to provide the individualised 1:1 service to each person. The Intermediate care service aims to encourage rehabilitation, as often as is practicable, with the intention of a return to a person’s own home or move on to an alternative placement once they have maximised their independent living skills. It is a well-established facility working in partnership with the local PCT, facilitating early discharge and preventing re-admission through rehabilitation, including physiotherapy, occupational therapy and a strong rehabilitation ethos / philosophy. “It’s been nice seeing you, but I don’t want to see you again in here…” - such was the farewell we heard from one person using the service to another as they departed, exemplifying the ethos / culture of the service. There are dedicated facilities in a therapy area and room, and equipment is situated throughout the home to promote and encourage service users to sustain their activities of daily living. The stairs within the home are regularly used to practice mobility skills. The local Trust deploys qualified Occupational Therapists and Physiotherapists and is also responsible for these professional’s supervision. Assessment documentation relating to the Intermediate Care service was thorough, with Rehabilitation Assessments and Personal Care Plans being in place alongside Manual Handling and associated Risk Assessments. The individual person concerned signed a statement of Aims and Goals for their programme. We found the daily records were comprehensive and detailed. Weekly Multidisciplinary team meetings are held to review the current people living on the first floor - the Visiting Medical Officer, amongst other health care professionals - as well as the Team leaders / management responsible for the Intermediate Care units attends this session. Ludlow Lodge Care Centre DS0000038481.V340375.R01.S.doc Version 5.2 Page 11 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): 7, 8, 9 & 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individual Care Plans are provided for people using the service from the outset, with a full assessment informing the focus leading to a plan of action - enabling the service to meet each person’s health, personal and social care needs. Health care needs are adequately and individually met; the home respects the right to choice of GP, keeping contact with many surgeries in the local area. The service is well respected by local general practitioners – indicating a focused and correct approach to the healthcare needs. The storage, administration and recording of medication is well organised, with staff being well trained and supervised - to ensure a safe service. Staff members relate respectfully and appropriately to service users, protecting the dignity and privacy of each service user. Ludlow Lodge Care Centre DS0000038481.V340375.R01.S.doc Version 5.2 Page 12 EVIDENCE: We found that care planning systems were maintained with a clear focus, and recording within the home was noted to be receiving more positive attention and was of a good quality. A comprehensive assessment of someone thinking of moving into the home is required, thus enabling staff members to have sufficient information about the individual when they are admitted. Risk and other individual assessments are completed as soon as practicable after an admission. Reviews of risk assessments and care plans are being regularly undertaken and documented. We heard that the care provided by staff to the people living at Ludlow Lodge was good; those directly using the service stated: “They’re all kind and gentle - they do their best for you…” - “a number of staff are outstanding - very caring…” Written questionnaires received back from relatives stated: “they provide personal care well - there is attention to routine and cleanliness - there are lovely, caring and helpful staff.” Another wrote: “All carers show great respect to my [relative]...always kind and patient.” and: “They look after their ‘clients’ 100 as far as I can see.” Hairdressing is provided in the day centre at a reasonable rate; toiletries, newspapers and other luxuries can be obtained or shopped for, as required. We observed the interaction between staff and service users throughout the visit - it was warm and familiar, but suitably respectful. We audited medication administration processes during the inspection visit; this showed they were managed correctly, and records seen were concise and accurate. Those using the Intermediate care service are encouraged to maintain independence and manage their own medication by staff handing them their medication at the appropriate times. Three GPs (from three of the four different local practices) answered the Commission’s questionnaire concerning how they found the service provided at the home; they commented positively on communication, assistance from staff, plans of care, promoting privacy, medication administration, and knew of no complaints - all were positive in the response indicating they were “satisfied with the overall care” provided at Ludlow Lodge. Ludlow Lodge Care Centre DS0000038481.V340375.R01.S.doc Version 5.2 Page 13 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): 12 - 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Both organised activities and the general lifestyles lived by people provide for meeting their individual needs, ensuring a level of fulfilment and satisfaction. Contact with the local community and friends and family are positively encouraged, this bringing the home into the community - and vice versa. The Intermediate Care therapeutic environment encourages visits from family and friends and contacts in the local community as appropriate. Within the context of encouraging independence and self-reliance, service users are expected to exercise their own choice and control, so promoting decisionmaking, self-esteem - and maintaining the impetus to ‘get back home’. The home seeks to ensure that autonomy and choice are afforded throughout the home; service users are encouraged to express themselves individually recognising their specific cultural and spiritual needs. The food provided at the home is wholesome and nutritious; choice and personalised service is provided, and individual preferences are acknowledged - through the small ‘Unit living’ approach of the home. Ludlow Lodge Care Centre DS0000038481.V340375.R01.S.doc Version 5.2 Page 14 EVIDENCE: The service at Ludlow Lodge has an ‘added quality’ with the ‘day care’ - and now the short-term ‘Intermediate Care’ culture running alongside the longterm care home itself. A number of those living at the home use the services provided by the day centre. These aspects bring a sense of ‘life’ to the home that is rarely evident in ‘stand alone’ care homes. Personal possessions and furniture lend a individual ‘air’ to bedrooms, and those living at the home have been clearly kept informed about the changes at the home - this leading to them feeling ‘at peace’ with the change going on around them. Activities arranged by the home include Barbecues, Outings, Shopping trips, outside entertainments (often as a joint venture with the day centre), and various local parish church activities and Services are made available. Internal home activities include: Bingo and table games, Exercise Classes / Physio, Library, Sing-a-longs, Reminiscence Sessions and Video Film Shows, Entertainment and parties. Service users who used to use the Day Centre still maintain a right to the service, this ensuring continuity of friendships, activity and outward focus. An Asian person living at the home attends a culturally appropriate club on a regular basis, maintaining links with his racial, religious and social roots. One person also speaks using an Ugandan dialect - the home has located staff / district nurse and agency workers who speak her specific language - which helps to supplement the small amount of English held. Some service users who have no clear representative in the guise of relatives or close friends – are connected with Advocates through Sutton Age Concern; this being especially important throughout the period of change and intensive consultation. A wide variety of food is provided; the kitchen catering for the home and 25 (maximum) in the day care centre. The menu plan was displayed in the Unit kitchens and offers a choice of food throughout the week - and also addresses individual dietary needs. Specific food is provided to people to meet their cultural preferences. Service users are asked what they would like to have, or select the choice from the menu on a daily basis. We found the dining areas in the Units are pleasant to sit in - friendly and homely, especially when the community comes together for their main meals. Breakfasts are served very informally to suit individuals on the Units, using provisions stored locally in the small Unit kitchens and refrigerators. Ludlow Lodge Care Centre DS0000038481.V340375.R01.S.doc Version 5.2 Page 15 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): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can be confident that their right to complain will be respected and any expressions of concern or complaint will be acted upon and dealt with in an appropriate manner - and that they are protected from abuse. EVIDENCE: The manager confirmed in the pre-inspection questionnaire that there had been no complaints received by the home since the last inspection visit and no restraint or adult protection issues had arisen. The home has a formal complaints procedure in place. Records held at the home showed that previous complaints had been dealt with appropriately, with deadlines heeded and all stated action taken by the home if any. The home has an easy-read accessible complaints procedure for service users. Advocacy services have been provided by the local Age Concern for service users without relatives / interested parties to help support people through the transformation of the home. The home has an Adult Protection and Whistle Blowing policy and procedure the corporate multi-agency Vulnerable Adult policy. Senior staff and many other staff members have attended the Borough’s Adult Protection training. The recruitment of staff and use of volunteers are covered through thorough referencing, CRB and PoVA checking mechanisms. Ludlow Lodge Care Centre DS0000038481.V340375.R01.S.doc Version 5.2 Page 16 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): 19 - 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can rely upon the home being well maintained to a safe and comfortable level, with generally appropriate furnishing and adequate facilities to meet their individual needs. Recent capital works and improvements have enhanced the facilities provided at the home considerably. Consistent ongoing maintenance and servicing checks / inputs by the staff and other professionals ensures a clean and hygienic home, and the service users’ health & safety. EVIDENCE: Part of the home’s planned refurbishment, and making ready of the home for the arrival of the Bawtree House service has led to the passenger lift being entirely refurbished. The call bell system within the home has been changed to an integrated ‘bleep’ system - which has reduced the disturbance from the previously noisy hard-wired system. The home has upgraded its security provisions throughout the building; all windows have window restrictors, and doors are connected to the call bell system. Ludlow Lodge Care Centre DS0000038481.V340375.R01.S.doc Version 5.2 Page 17 All bedrooms and lounges have now been fitted with the ‘dorgard’ facility that enables the door to be held open until such times as a fire emergency is alerted by the fire bells. Lighting in all the corridor areas has been enhanced to ensure clear pathways and safety. The first floor facility has been redecorated and refurbished to provide the ’new’ service from Bawtree house with an environment ‘fit for purpose’. There are 40 places in single bedrooms registered at the home; two have ensuite facilities. There are six Unit areas, with eight lounges and a visitors’ room provided. The home is a pleasant relatively modern establishment, even though the external ‘feel’ of the house is somewhat plain and gloomy. The home facilitates group living within six discrete units - and all areas are accessible to service users. The home’s general decorative state remains in relatively good condition throughout. An induction loop system is installed in each of the service user’s sitting rooms - to enable better hearing for hearing aid users. The home provides one assisted bath in each of the six units. A ground floor accessible toilet is available on the ground floor for disabled persons at the home. This is no doubt a great benefit to all who find it easier to use rather than the previous inadequate / small facilities. We found the house to be clean and odour-free throughout during the time of the inspection. The home has access to Community Occupational Therapy services for people who live at Ludlow on a long-term basis needing assessment for equipment; the home has mobile hoists for moving and handling purposes. The courtyard and garden areas are well appreciated; the immediate outlook to the gardens is pleasant, and people using the service long-term remained happy with the decision to occupy the ground floor rather than the first. Ludlow Lodge Care Centre DS0000038481.V340375.R01.S.doc Version 5.2 Page 18 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): 27 - 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The staffing input at the home is provided in numbers and skills-mix to a level that meets the assessed and recorded needs of service users. Staff members are sufficiently trained - both in local and vocational disciplines - and suitably supervised to ensure that the service users are in safe and competent hands at all times. The registered provider supports the home through its recruitment and employment procedures and practices to ensure that diversity and equality is promoted and that service users are protected from potentially abusive staff. EVIDENCE: “There seems to be a good skills mix.” - thus commented a relative - and all questionnaire feedback made a point of appreciating the staff and their competence. Another was complementary about the team: “The manager down to all the staff run a very good home….” - thus stated a relative who visits the home ‘at their convenience’ - and so gains a random impression of the service at varying times. To cover all the living units at the home, 30 permanent care staff (22 day and 8 night workers), seven seniors, the manager and thirteen ancillary staff are employed. Three night staff members are available, awake, each night - one a Ludlow Lodge Care Centre DS0000038481.V340375.R01.S.doc Version 5.2 Page 19 senior. There have been five staff members (amounting to three full time posts) leaving the service more recently, for retirement / career move reasons. With the coming together of two staff teams to provide an input for the one service, the ‘establishment’ is well provided for - all staff members have been recruited using the thorough London Borough of Sutton recruitment procedure, ensuring that references and checks - including Criminal Records Bureau declarations - have been satisfactory before starting a worker on shift. Staff training input had increased during the preparation for the blending of the two teams from Ludlow Lodge and Bawtree House; a wide variety of input - including focusing on person-centred support has been covered. As part of the staff integration strategy, training for all care staff ensures that they are ‘singing from the same hymn sheet’. We saw an excellent staff training strategy so far covering Adult Protection / Infection Control / Care of Medication / Person-centred Support. Diversity Training for staff is mandatory. Training records are well kept with complete lists of people’s skills informing future input. We found that thirty-six staff held a current Emergency First Aid qualification - thus covering the rota at all times. We saw a full staff training record / matrix for staff. Most care staff members have qualified [minimally] to Level 2 NVQ in Care; the figure of 88 being well in excess of the 50 minimum standard set. The stated goal of Sutton Council is for all care staff in the Council’s care centres to have at least a basic NVQ. The manager of the home is approaching the finish of her NVQ Internal Verification course. Team leaders are planning to undertake their Level 4 - to reflect their being ‘in charge’ at times. This approach is commendable reflecting the skilled ‘specialism’ of Intermediate Care services. All permanent care staff who work independently on Units are trained to administer medication and seniors have been trained in reviewing / assessing staff competency in this particular important area. Support for the staff during the transition / amalgamation of the two separate services had, it was acknowledged, been difficult, they told us, but now that the service was ‘up and running’ the general feeling was that the team was ‘getting it together’ and there was a better feeling of single purpose developing. Staff appraisals were being rolled out, with the manager and deputy manager having received theirs, and now, by cascade, the remaining seniors and care staff would receive theirs. Staff supervision in general is managed / overseen by the deputy manager. Ludlow Lodge Care Centre DS0000038481.V340375.R01.S.doc Version 5.2 Page 20 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): 31, 32, 33, 35, 37 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is suitably qualified and competent to ensure that the overarching service is provided in a professional and service user-focused manner, and that the service provided is run in the best interests of the service users through clear leadership and management support. Service users can be confident that their financial interests will be safeguarded by the home’s appropriate management and accounting / financial procedures. The registered provider, through a process of updating policies and procedures, ensures that best practice is known and adopted, based on this relatively new documentation. Service users will benefit from this new information being available to staff and other stakeholders. The registered provider positively promotes the health & safety of service users and staff through regular maintenance and checks of facilities. Ludlow Lodge Care Centre DS0000038481.V340375.R01.S.doc Version 5.2 Page 21 EVIDENCE: The manager, Rita Collier oversees the entire service at Ludlow Lodge, the day care service included, though it is managed on a day-to-day basis by one of the home’s senior staff. She holds a Diploma in Management Studies and has completed her Level 4 NVQ in Care. All other necessary statutory training elements are also held. It is clear that her knowledge, experience - and evident enthusiasm and commitment to the home - is an asset to this service. She has managed Bawtree House prior to moving with the service to Ludlow, and has many years of hands-on experience. We found the home has an effective management structure of manager and deputy manager (a qualified social worker), and with senior care staff managing the units and associated teams of staff. Areas - such as care planning, medication, staff training and activities & outings - are designated areas held in additional responsibility by each senior carer. An excellent Unit / Team Development Plan - with cross-references to the National Minimum Standards and Regulations - was made available, showing how all the various elements of staff training and input would affect the outcomes for users of the service. Sutton Council - as the registered provider, is required, under Regulation 26, to ensure that a monthly, unannounced visit is made to the home by an appointed representative to inspect the conduct of the home - and to make a report of this visit for the information of the registered provider, and also the Commission. The home manager confirmed that she now has to complete a monthly self-assessment form on behalf of the home for the organisation - and that this forms the basis of discussions about the conduct of the home. Over the past six months the Commission has only received one or two of these Regulation 26 monthly reports. Whilst it is undoubted that the service manager and other visitors visit the home on a regular basis, the report’s receipt at the Commission should confirm the consistency of these visits. An independent person ‘rota’ has been seen for these visits - so it is the administrative management of the reports that appears to be at fault. The financial interests of people using the service long-term are safeguarded by the home; the accounting of monies at the home held in safekeeping and local administration processes have been examined and found concise and well maintained. Individual receipts are signed to receive monies paid as personal allowance; transactions are undertaken in the home within a context of privacy and appropriate recording management. Six long-term people have their affairs managed by the by the Council’s Client Finances Officer. Such finances are regularly declared by ‘statement’ to the person involved. Ludlow Lodge Care Centre DS0000038481.V340375.R01.S.doc Version 5.2 Page 22 The provision of single occupancy rooms throughout the home equally provides for the respect for, and protection of, each individual’s security and privacy. A lockable facility in bedrooms is provided for each person resident at the home. Due to the short-term transitional approach used by the Intermediate care service, it is extremely unusual for the home to take responsibility for any money or possessions in this sector. The person - or a relative - normally deals with these aspects. Each has a lockable facility in their room and bedroom doors are also lockable. The local authority has procedures in place should this provision of ‘safekeeping’ be necessary, however the ethos of self-help / independence pervades in all areas. We found all in-house and external maintenance and servicing activity for the premises were up-to-date and evidenced by thorough, well kept and ordered records in the premises manual. Such measures ensure the safety of service users. Ludlow Lodge Care Centre DS0000038481.V340375.R01.S.doc Version 5.2 Page 23 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 4 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 2 X 3 X 3 3 Ludlow Lodge Care Centre DS0000038481.V340375.R01.S.doc Version 5.2 Page 24 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 OP33 Regulation 26 Requirement Regulation 26 visits by a representative of the registered provider must be evidenced in writing and copy provided to the Commission’s local office. Timescale for action 30/11/07 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 OP22 Good Practice Recommendations That the downstairs furnishings & furniture - especially in the kitchenettes - should be reviewed to ensure that all parts of the home are kept to the same quality standard. Ludlow Lodge Care Centre DS0000038481.V340375.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 Ludlow Lodge Care Centre DS0000038481.V340375.R01.S.doc Version 5.2 Page 26 - 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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