Inspection on 05/04/05 for Lydiate Lodge

This inspection was carried out on 5th April 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Lydiate Lodge 04/07/06

Lydiate Lodge 04/10/05

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 Patricia Hellier Announced 5 April 2005 th 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 Crispin’s, 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 Version 1.10 Page 3 SERVICE INFORMATION Name of service Lydiate Lodge Address Rock Lodge Park, Lynton, Devon. EX35 6DN 01598 753256 01598 752661 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) Devon County Council Carol Ann Mitchell Care Home providing Personal Care 15 Category (ies) of TI OP registration, with number Terminally Ill [1] of places Old Age [15] LYDIATE LODGE Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 14.09.2004 Brief Description of the Service: Lydiate Lodge is a Local Authority home registered for 15 people over the age of 65. The home has long stay beds, respite beds and a bed designated for terminal care. Seven beds are currently out of use as building work is being conducted. All rooms are being refurbished to include ensuite facilities. There is good wheeelchair access and an easlily operated lift to the first floor The home is a purpose built 1960s property situated in a quiet area of Lynton opposite the tennis courts. It is a two-storey property approached from a culde-sac with parking in front. Access to the home by car is on a downhill incline but a level footpath leads from the side of the building to the level High Street. All local facilities are within easy walking distance but some are closed in winter. Dedicated sitting areas at the front and a patio area at the side allow for good weather activities outside. Garden furniture is provided. Provision is made within the home for a variety of activities and outings which also enable close links with the local commumity to be maintained. LYDIATE LODGE Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over five and a half hours on 5 April 2005 and one and half hours on 20 April 2005. The Registered Manager, Carol Mitchell, was present during the inspection. All residents and members of staff on duty also took part in the inspection. The second inspection visit was to see the staff files that are not normally kept in the home. The inspector looked around the new wing of the building (which is still under construction) as well as the parts of the building currently in use. A number of records were inspected, which included pre inspection questionnaire, comment cards from other professionals who visit residents in the home, thank you letters from relatives, staff files and a recent service user survey and results. What the service does well: What has improved since the last inspection? What they could do better: Some employment records do not hold all the required information to ensure the protection of residents this information must be obtained. The hand washing facilities for staff in residents’ rooms needs to be reviewed to provide adequate facilities to prevent the spread of infection. LYDIATE LODGE Version 1.10 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. LYDIATE LODGE Version 1.10 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 LYDIATE LODGE Version 1.10 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 and 3 The Residents’ guide is comprehensive and provided prospective residents with information to make an informed choice. The home’s assessment process is thorough and ensures that it is able to meet residents’ needs. EVIDENCE: Residents are provided with a comprehensive Residents’ booklet containing the Statement of Purpose and all the information required to ensure they or their relatives have access to the relevant information at all times. Care needs are well met through a full assessment process and the completion of a care plan from this information. The assessment includes all the elements listed in the standard. A comprehensive assessment was seen for a recent short-term resident. The resident when spoken to said ‘I am well looked after they know what I need’. LYDIATE LODGE Version 1.10 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service users’ 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 benefit from care plans that are well formulated and give clear information to enable staff to meet residents’ health and social care needs. Personal and environmental risks are well managed. EVIDENCE: Individual records are kept for each of the residents and inspection of the records for one short-stay resident and two longer-term residents contained well-formulated risk assessments for Manual Handling and falls. Other personal and environmental risk assessments were present to ensure the safety of the resident while promoting independence as able. The care plans clearly identified health and social care needs and actions to meet these needs. Residents spoken to confirmed the staff were well aware of their needs and did everything to meet them. For example one resident said ‘they notice when you are unwell and come and help you’. A short-stay resident said ‘they are absolutely lovely and I would always come back here.’ The interactions of the care staff observed demonstrated respect for individuals and their right to privacy. Residents spoken to said ‘the staff are very thoughtful and kind and treat you very well’. Two residents said they did not like the attitude of 2 or 3 members of staff. LYDIATE LODGE Version 1.10 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, 15 Social activities and meals are both well managed, creative and provide daily variation and interest for people living in the home. EVIDENCE: All the residents said that the ‘food is good’ and that they liked the daily choices offered. For example one resident said ’if you don’t like something they’ll change it’. Menus showed a varied, balanced and nutritious diet. The meal on the day of inspection reflected this. Care staff take responsibility for arranging activities on a rota basis and provided a weekly programme of activities, outings and events. All residents said that they liked the outings and two residents said they enjoyed the church service they have. LYDIATE LODGE Version 1.10 Page 11 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) 16,18 Residents are confident that they are listened to and their requests acted upon. Staff do not fully understand the adult protection procedures and this potentially places residents at risk. EVIDENCE: The home has a detailed complaints procedure that is well displayed and all residents have a copy of. There have been no complaints and residents stated that if they were not happy about anything they would speak to the manager. Staff and residents spoken to, say the manager is very approachable and understanding. One service user said ‘I’ve nothing to complain about, it’s the best home in the area’. A procedure for responding to allegations of abuse is available however staff were not fully aware of this, but were to attend training in the next few days. Staff said they had never seen any signs of abuse in the home and demonstrated a good understanding of what constituted abuse. One resident who requires to be hoisted from chair to bed said they felt very safe with the staff. LYDIATE LODGE Version 1.10 Page 12 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) 19,23,26 Residents are provided with safe, comfortable surroundings. Infection control practices require some attention. EVIDENCE: Building and refurbishment works are continuing. Attention has been made to the safety of residents and staff with good environmental risk assessments and fire safety measures in place. Disturbance for the residents during this work has been minimal. The current living accommodation is well decorated and homely. Residents’ rooms are personalised and comfortable. The home is clean and pleasant. The lack of dispenser soap and hand towels, or alcohol gel, in residents’ rooms gives rise to poor infection control practices. The sluice area had a strong odour due to lack of ventilation since commencement of the building works and also lacks hand-washing facilities. LYDIATE LODGE Version 1.10 Page 13 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 The numbers and skill mix of competent staff are sufficient to meet residents’ needs. The procedures for the recruitment of staff are inconsistent and do not always provide the safeguards for the protection of people living in the home. EVIDENCE: Residents spoken to said that the staff were kind and caring and always there to help. During the visit staff were observed spending time with residents and call bells were answered quickly. There is a low turn over of staff but some new staff have recently been employed. The staff files of seven staff members employed at varying times showed inconsistency of Criminal Records Bureau (CRB) checks and 5 files contained no proof of identification. One staff file had no references and no CRB check. Two staff members were spoken to; one said she had completed an application form and neither knew if they had completed a CRB form. All staff have received first aid and fire safety training recently. Staff spoken to said that there was lots of training and records seen showed attendance at a variety of relevant training sessions. Staff spoke of regular supervision and assistance in gaining NVQ qualifications. LYDIATE LODGE Version 1.10 Page 14 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) 32,33,36,37,38 The manager provides clear leadership and guidance to staff to ensure residents receive consistent care in a safe environment EVIDENCE: The manager gives clear leadership, guidance and direction to staff. Staff stated that some of the assistant managers do not always provide the same clear guidance and direction. Residents feel the manager is approachable and seeks to ensure all their needs are met. Quality assurance measures are in place to ensure the monitoring of standards and that the residents have a say in the running of the home. A recent residents survey shows that all of the residents felt the home is satisfactory, but would like bigger rooms and some new furniture. They all praised the staff and said they liked living at the home. Monthly visits by the Registered provider are not being carried out. Records inspected indicated regular safety and fire checks are carried out. Staff spoken to confirmed that regular fire instruction and drills had taken place LYDIATE LODGE Version 1.10 Page 15 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x 3 x 2 STAFFING Standard No Score 27 3 28 x 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x 3 3 x x 3 1 3 LYDIATE LODGE Version 1.10 Page 16 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 OP29 Regulation 19.1 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 not met). Where the registered provider is an organisation, the care home shall be visited in accordance with this regulation by (a) the responsible individual or one of their partners as may be case, (b) another of the directors or other persons responsible for the management of the organisation; or (c) an employee of the organisation who is not directly concerned with the conduct of the care home. Visits shall take place at least once a month. (Previous timescale of 14/12/04 not met) Timescale for action 20/06/05 2. OP37 26.1 20/06/05 LYDIATE LODGE Version 1.10 Page 17 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 OP18 OP26 Good Practice Recommendations The provision of Adult Protection training for all staff The implementation of adequate hand washing facilities for staff when in residents’ rooms. LYDIATE LODGE Version 1.10 Page 18 Commission for Social Care Inspection Exeter Office, 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 Version 1.10 Page 19 - 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!