Random inspection report
Care homes for older people
Name: Address: Madeira Lodge 38/40 Birnbeck Road Weston Super Mare North Somerset BS23 2BX two star good service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: John Clarke Date: 1 1 1 1 2 0 0 9 Information about the care home
Name of care home: Address: Madeira Lodge 38/40 Birnbeck Road Weston Super Mare North Somerset BS23 2BX 01934621846 01934414668 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Derek Herbert Butler care home 40 Number of places (if applicable): Under 65 Over 65 40 old age, not falling within any other category Conditions of registration: 0 To admit one named service user aged less than 65 years for respite care. Date of last inspection Brief description of the care home Madeira Lodge is registered to accommodate up to 40 people who are in the category Older People over 65 years. The home comprises of two adjacent properties overlooking Weston Bay, there are panoramic views across the bay from the communal areas at the front of the houses. All rooms have en-suite facilities and a number have attractive sea views. There is limited parking on a short sloping driveway. Madeira Lodge is owned by Mr and Mrs Butler, Mrs Butler has some minimal management input into the overall running of the business. Care Homes for Older People Page 2 of 9 What we found:
This inspection was undertaken as a result of concerns we had received from three individuals. They related to health and safety, staffing of the home and arrangements for the providing of meals. There were also concerns about the general care being provided and environment of the home. We looked at the care provided for one individual whose health had deteriorated and was being visited by a district nurse. It was unclear from records how pro-active the home had been in responding to the needs of this individual. Records of district nurse visiting were not completed. There were no assessments completed about specific areas of care namely skin integrity or nutrition and these were areas of concerns. At the time of our visit investigations had been arranged and district nurse was visiting daily. It was noted that as part of this individuals daily care staff were not recording fluid intake or frequency of turning. The manager confirmed that staff had not received training in this area of care namely supporting individuals who are at risk of pressure sores or poor nutrition. We asked individuals about the care they received and there were positive comments perfect staff care and attention is brilliant get the care we need. However individuals told us that there are not enough staff in rush staff always very busy. We looked at staffing rotas and noted that there are generally 2 staff on duty from 8am (8-2,8-6), 2 10-8 and one 2-8 with two waking night. We spoke with the cook about the meals provided and they told us that fresh produce and local meats are purchased as part of the menu planning. There was variety of meals available with daily choice. There was no evidence of poor quality products being used to provide meals. Individuals we spoke with were all positive about the meals and on the day of our visit the meal was attractive and well presented. We looked at the environment and also spoke with a number of individuals who live in the home. Whilst they were generally satisfied particularly with the individual accommodation there was dissatisfaction expressed about lighting provided in the communal areas particularly the lounge/dining room. This lighting was in our view inadequate for older people and did not provide an environment which met individuals needs. It was also noted that areas of the home not in use were in a poor condition and unused furniture stored in boiler room area. It was also noted that one toilet needed re-decoration because of water leak and tiles were in poor condition and no towel or hand drying facilities provided . It was evident in walking around the home that there are areas requiring updating and improving particularly the entrance hall where again lighting was poor and carpeting dated and faded in places. This did not provide an attractive and welcoming environment rather presenting as tired and rundown. As discussed with the manager at the time of our visit it is almost at the point of looking dilapidated. Other facilities such as toilets and bathrooms were in need of updating and in the inspectors view clinical and cold. It was noted that one toilet had been updated with new cistern and re-decoration. Individuals we spoke with all commented on the improvement made following redecoration and landscaping of the front of the home and how this made the home more inviting and attractive. What the care home does well:
Care Homes for Older People Page 3 of 9 Over the past months there have been significant changes in the management of the home which has led to a number of staff leaving the home including the manager. The previous manager has now returned to the home as well as a number of staff though there remains staff vacancies. This clearly caused disruption and from talking with individuals and staff has been an unsettling and in some respects upsetting period. However we were told by a number of individuals who live in the home of their satisfaction with the staff in the home and generally the care they receive. From talking with staff and the manager there is a strong commitment to the home and this has in the inspectors view reduced the impact of the disruption which has been caused as a result of actions of the owner of the home however well intentioned they may have been. We are satisfied that the arrangements for the providing of meals in the home are satisfactory and individuals we spoke with were positive about the quality and choice available. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 4 of 9 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 5 of 9 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 7 12 The registered manager shall 30/01/2010 make sure that the care home is conducted so as to promote and make proper provision for the health and welfare of individuals living in the home. This relates to having the required assessment tools to identify level of risk and take the necessary steps to alleviate risk to individuals health and welfare. So that care needs are met in a competent and professional manner. 2 19 23 The registered manager shall 27/11/2009 make sure that the premises to be used as the care home are of sound construction and kept in good state of repair externally and internally. This is in reference to the downstairs toilet adjacent to the lift which must be repaired and re-decorated so that it is at the required Care Homes for Older People Page 6 of 9 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action standard of decoration and hygiene. 3 25 23 The registered manager to make sure that lighting is suitable for individuals living in the home. This relates to the need to have lighting adequate and meeting the needs of individuals living in the home. 4 27 18 The registered manager shall 30/01/2010 make sure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of individuals living in the home. This relates to the home reviewing staffing arrangements and to have in place means to measure needs of individuals. The home should refer to Department of Health Residential Home staffing guidence. This to ensure there are adquate staffing on duty at all times to meet the assessed needs of individuals in the home. 5 30 18 The registered manager shall 30/01/2010 make sure that the persons employed to work at the care home receive training appropriate to the work they are to perform.
Page 7 of 9 30/01/2010 Care Homes for Older People Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action This refers to the training of staff specifically in relation to caring for individuals whose health and welfare is at risk because of poor skin integrity and nutrition. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations 1 19 The registered manager to undertake audit of the homes environment and identify areas for improvement and put in place an action plan and timescale to undertake the identified improvements. To provide a copy of the action plan to ourselves by 01/01/10. To ensure the health and safety of those who live and work in the home too take action to remove potential fire hazard namely stored furniture. To advise ourselves by 01/01/10 of action or planned action in relation to removing of furniture in these areas specifically adjacent to boiler room. 2 38 Care Homes for Older People Page 8 of 9 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 9 of 9 - 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!
