Inspection on 04/10/05 for Lydiate Lodge

This inspection was carried out on 4th October 2005.

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

Lydiate Lodge 04/07/06

Lydiate Lodge 05/04/05

Lydiate Lodge 14/09/04

Lydiate Lodge 17/06/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Lydiate Lodge Rock Lodge Park Lynton Devon EX35 6DN Lead Inspector Victoria Stewart Unannounced Inspection 4th October 2005 11:30 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 Lydiate Lodge DS0000039201.V249576.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Lydiate Lodge DS0000039201.V249576.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Lydiate Lodge Address Rock Lodge Park Lynton Devon EX35 6DN 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) 01598 753256 01598 752661 Devon County Council Carol Ann Mitchell Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15), Terminally ill (1) of places Lydiate Lodge DS0000039201.V249576.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th April 2005 Brief Description of the Service: Lydiate Lodge is a local authority home registered for 15 people over the age of 65 years. The home accommodates both long and short (respite) stay residents. The home is also registered to admit one resident requiring terminal care. Lydiate has recently undergone complete refurbishment and now provides single rooms, a large number with en-suite facilities, and has up to date and modern equipment installed throughout. Communal areas are sited on both floors. Outside seating areas are provided. Lydiate is purpose built and situated off the main road leading to the tourist town on Lynton, North Devon. It is a two-storey building with private parking to the front and side of the property. The facilities of the local high street are within walking distance. Lynton has a good community spirit and is closely linked with its twin town of Lynmouth. Lydiate Lodge DS0000039201.V249576.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second statutory inspection of the current year and was unannounced. The Registered Manager, Carol Mitchell, was present during the inspection. There were 12 service users admitted in the home with 3 vacancies. The previous inspection of 5th April 2005 found that many of the core standards were fully met with 2 requirements and 2 recommendations made. All remaining core standards not looked at during the earlier inspection were inspected on this visit, along with the progress to meet the requirements and recommendations identified. Both of these reports should be viewed in conjunction with each other to provide a full picture of the home. During this visit, the inspector spoke with several residents in private and one relative. A tour of the building was undertaken and the latest developments in the refurbishment programme seen. Some records were looked at. Positive discussion took place during the inspection and the opportunity to explore the current variation to change the home’s registration category with the CSCI was taken. What the service does well: What has improved since the last inspection? Building works are almost complete. The home has been transformed and modernised to provide a high quality and comfortable environment for residents to live in. Monthly visits are now being regularly undertaken to monitor the running of the home. Lydiate Lodge DS0000039201.V249576.R01.S.doc Version 5.0 Page 6 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. Lydiate Lodge DS0000039201.V249576.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Lydiate Lodge DS0000039201.V249576.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 fully met the standard at the last inspection 6 Residents with intermediate care needs are not admitted to the home. EVIDENCE: Lydiate Lodge does not provide intermediate care facilities. The home’s statement of purpose was briefly looked at during the inspection in support of the current variation of registration which is seeking approval from the CSCI. This was discussed with the manager and suitable amendments, additions and updating of this document were suggested to reflect the recent refurbishment and the resident groups applied for. The manager said that the current statement of purpose is being re-organised as a Devon County Council corporate document and that she intends to use this when available. Lydiate Lodge DS0000039201.V249576.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,10 fully met the standard at the last inspection 9 Medication administration at the home is well managed and residents protected from any risk. EVIDENCE: The system for the administration of medicines is managed very well and records kept are comprehensive and clear, although time consuming for the staff involved in the process. Designated senior staff are responsible for the handling of all aspects of medication and are suitably trained. Medicines are kept securely in a separate designated room. The home does not currently have the facility available for a Monitored Dosage System (MDS) for the dispensing of medication and as a result medication takes a lot longer than it should. Residents would benefit from an MDS by freeing up some of the staff’s time by making the process much quicker and safer. After some discussion the home is now looking at an alternative pharmacy supplier who may be able to provide Lydiate with the MDS. Should residents wish to self medicate, suitable facilities, policies and documentation is provided. The home has a separate medicine fridge which is kept in a cool room. Whilst the fridge does have a temperature setting displayed, there is no routine recording of the temperature. This must be done if keeping medication in it for example insulin. Lydiate Lodge DS0000039201.V249576.R01.S.doc Version 5.0 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,15 fully met the standard at the last inspection 12,13,14 Meals are well received and provide nutritious and wholesome food for residents. Social activities are offered but scanty and limited. Visitors and relatives are made to feel welcome by staff at the home. EVIDENCE: Residents confirmed that they liked the food. Since the last visit, a new cook has been employed and is providing a good service. Copies of menus and discussion with residents confirmed that a choice of three meals and desserts offered at lunch and tea. Special diets are catered for. A common comment from residents reply was that “food is very nice”. Residents and relatives confirmed that they are made to feel welcome at any time and enjoy hospitality whilst visiting is offered in the way of beverages or meals. Informal and friendly interaction was observed between staff and relatives during the inspection. The manager acknowledged that current leisure and social activities are limited and could be improved. This is due to the building work taking place both in Lydiate Lodge DS0000039201.V249576.R01.S.doc Version 5.0 Page 11 and outside of the home, particularly in the summer. Most of the residents accepted this but two told the inspector “We like quizzes but what else is there to do?” Care assistants rotate the in-house activities on offer such as bingo, quizzes and church visits. The yearly Christmas lunch outing had recently been booked when all the residents look forward to being taken to a nearly local pub/restaurant with staff accompanying them. Residents exercise choice and control over their lives. One resident was seen being served her breakfast in bed at 11 am after enjoying having a ‘lie-in’. Lydiate Lodge DS0000039201.V249576.R01.S.doc Version 5.0 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 the following standard(s): 16 fully met the standard at the last inspection 18 partially met the standard at the last inspection and reassessed during this Visit 18 Arrangements for the training of staff in the protection of vulnerable adults are satisfactory, but senior staff would benefit from taking a recognised training course. EVIDENCE: Several members of staff have attended protection of vulnerable adults training. The manager explained that the local Devon County Council Protection of Vulnerable Adults course has been very difficult to access with no places available. Records demonstrated that all staff watch the ‘No secrets’ video and read the accompanying booklet ‘Alerter’s Guide’ in order to provide training in recognising abuse. No complaints have been received since the last inspection and residents spoken with did not have ‘any reason to complain’. Lydiate Lodge DS0000039201.V249576.R01.S.doc Version 5.0 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 the following standard(s): 19 fully met the standard at the last inspection 26 partially met the standard at the last inspection 20,22,23,24,25,26 Recent investment has significantly improved the appearance of the home creating a quality, safe and comfortable environment for those living there and visiting EVIDENCE: The home is still in the process of being updated in several areas. Many workmen were present in the home on the day of inspection busily laying carpets, painting and plumbing. This caused minimal disruption to residents and was being handled very well. A new seating area outside of the building has been developed and secured to provide safety and privacy. A new car parking area has also been provided to the side of the home, which provides suitable parking for visitors and staff. The local fire service has visited the home during all stages of the refurbishment and all their requirements adhered to. Lydiate Lodge DS0000039201.V249576.R01.S.doc Version 5.0 Page 14 The laundry room has been updated and now provides suitable washing and drying equipment, hand washing facilities and an ironing area. The home now has 4 bedrooms on the ground floor with 3 having private ensuite facilities. The fourth bedroom has a communal WC very close. On the first floor the layout is essentially in an L shape in two areas, providing the home with a further 11 bedrooms, some with ensuite facilities. All bedrooms in the home have been completely refurbished and modernised to a very high standard, with modern, homely and high quality furniture and fittings. Residents are also encouraged to bring in their own personal and sentimental items of furniture. The home has two separate well-sited communal lounges on the first floor, each at the end of a corridor, along with a separate hairdressing room. On the ground floor is a further two communal lounges, one adjacent to the front of the building and one quiet room which leads on a patio area at the rear/side of the building. The home also has a large dining room suitable for all residents which is directed sited next to the kitchen area. The home has suitable bathroom/shower and WC facilities, all within easy reach of private and communal areas. The bathrooms have also been updated and refurbished to a high standard and are appealing, well laid out and contain modern up to date equipment. Access to all areas of the building is provided by a new 8-person shaft lift. Digital safety locks have been installed in some areas of the building for safety reasons. Door signage is to be fitted shortly. Ample storage facilities are well provided for on each floor. An up to date alarm call system has been updated to take into account the new rooms and the system is portable. Lydiate Lodge DS0000039201.V249576.R01.S.doc Version 5.0 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 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): 27,30 fully met the standard at the last inspection 29 did not meet the standard at the last inspection and will be assessed on the next visit 27,28,29 Residents’ needs are currently being met the number and skill mix of staff. The procedures for the recruitment of staff are inconsistent and inconsistent and do not always provide the safeguards for the protection of people living at the home EVIDENCE: On the day of inspection the staff group included the manager, assistant manager and two care staff. Both the care staff had been employed from an agency but residents’ needs appeared to be being met. One agency employee had worked at the home on previous occasions and it was noted that he knew the residents well. The other agency member of staff was on her first visit to the home. She confirmed that she had been shown around, ‘looked after’ and that she ‘loved working at the home’. In the event of agency staff being used, the home requests staff that have worked there before. Staff files were not available in the home as this inspection was unannounced. These files are not currently held on the premises but at a centralised location. The inspector will assess these files at the next inspection visit. The manager told the inspector that she thought these files would not fully meet the standard required. Lydiate Lodge DS0000039201.V249576.R01.S.doc Version 5.0 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 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): 32,33,36,38 fully met the standard at the last inspection 37 did not meet the standard at the last inspection 31,35,37 Residents live in a home that is well managed and run. Residents’ finances are safeguarded. EVIDENCE: Regular unannounced monthly visits to the home are carried out and a copy forwarded to the CSCI. The manager is well qualified and experienced to run the home. A team of assistant managers supports her and senior care officers. Roles and responsibilities are delegated and a team runs the home. Lydiate Lodge DS0000039201.V249576.R01.S.doc Version 5.0 Page 17 Records relating to the handling of residents’ monies were checked and found to be satisfactory. Suspense accounts are held for some residents and individually controlled. Lydiate Lodge DS0000039201.V249576.R01.S.doc Version 5.0 Page 18 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 1 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X 3 X Lydiate Lodge DS0000039201.V249576.R01.S.doc Version 5.0 Page 19 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 OP29 Regulation 19 Requirement The registered person must not employ a person to work in the care home unless he has obtained in respect of that person the information and documents specified in paragraphs 1 to 7 of Schedule 2 (Previous timescale of 14/12/04 and 20/06/05 not met). Timescale for action 04/01/05 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 2 Refer to Standard OP12 OP18 Good Practice Recommendations It is recommended that the home review its leisure and social activities. It is recommended that management and senior staff attend the formal Devon County Council Protection of Vulnerable Adults training to cascade to other staff. Lydiate Lodge DS0000039201.V249576.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 Lydiate Lodge DS0000039201.V249576.R01.S.doc Version 5.0 Page 21 - 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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