Inspection on 30/04/08 for Maple Lodge Care Centre

This inspection was carried out on 30th April 2008.

CSCI found this care home to be providing an Good service.

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

Maple Lodge Care Centre 02/05/07

Maple Lodge Care Centre 23/11/06

Maple Lodge Care Centre 06/07/06

Maple Lodge Care Centre 14/02/06

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Maple Lodge Care Centre (Scotton Gardens) Scotton Richmond North Yorkshire DL9 4LZ Lead Inspector Rachel Martin Key Unannounced Inspection 30th April 2008 09:30 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 Maple Lodge Care Centre DS0000066447.V362046.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. Maple Lodge Care Centre DS0000066447.V362046.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Maple Lodge Care Centre Address (Scotton Gardens) Scotton Richmond North Yorkshire DL9 4LZ 01748 834029 01748 831008 maple.lodge.richmond@fshc.co.uk www.fshc.co.uk Four Seasons (DFK) Limited (wholly owned subsidiary of Four Seasons Health Care Limited) Mrs Susan Margaret Alderson Care Home 60 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) Category(ies) of Dementia - over 65 years of age (10), Mental registration, with number disorder, excluding learning disability or of places dementia (1), Mental Disorder, excluding learning disability or dementia - over 65 years of age (10), Old age, not falling within any other category (50) Maple Lodge Care Centre DS0000066447.V362046.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service Users to include up to 50 (OP), up to 10 (DE(E)) and up to 10 (MD(E)) up to a maximum of 60 Service Users The Category MD refers to one named Service User Date of last inspection 2nd May 2007 Brief Description of the Service: Maple Lodge is a purpose built care home, which was built in 1991. It provides nursing and social care for up to 60 older people, including a separate 10bedded unit for people needing more specialist dementia care. The home is part of the Four Seasons Health Care group. The home is a single storey building, located in a pleasant rural location, near the garrison town of Catterick. It has extensive grounds to the rear, garden areas and car parking at the front of the building. At the time of this inspection the fees varied from £441-£500 per week. There are additional charges for chiropody, hairdressing, papers and toiletries. Up to date information about fees and terms and conditions should be sought from the home’s manager. Maple Lodge Care Centre DS0000066447.V362046.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. This was a key inspection of an existing service. Before the inspection the home’s manager completed a self-assessment and returned it to CSCI. This assessment told us what the home did well, what needed to be improved and provided information about the service, its staff and the people living there. Eight people living in the home completed and returned surveys about their experiences of living at Maple Lodge. Seven of these people had received support from the home’s staff to complete their surveys. Seven relatives of people living at Maple Lodge, twelve of the home’s staff and one health care professional also returned surveys. The inspection site visit took place on 30th April and was carried out by one inspector. During this visit the inspector spoke to the home’s manager, staff and people living in the home. A selection of records were inspected and the inspector looked around the building. Time was also spent observing the lunchtime meal and some of the care practices at the home. What the service does well: The home has in place good systems for assessing people’s needs and recording the care and support that people need. Records are kept up to date and contain valuable information about people’s need. All eight people living in the home who returned surveys said that they ‘always’ received the care and support they needed. Seven out of eight people said ‘yes’ the staff listened and acted on what they said. Comments made to us by people living in the home included ‘carers are excellent, I like all the staff’, ‘I’m settled, I want to stay here, the staff are lovely’ and ‘I think the care is excellent, the girls are all very kind and I have no complaints whatsoever’. A new activities coordinator has been employed and people felt that activities in the home had improved recently. Activities are arranged on a group and individual basis. They include, quizzes, entertainers, having make up and nails done, baking and gardening. Information is made available to people about making complaints or raising concerns and people feel that they can approach staff if they have a problem. Comments included ‘when I have suggested improvements weve discussed it Maple Lodge Care Centre DS0000066447.V362046.R01.S.doc Version 5.2 Page 6 and it has been acted upon’ and ‘the staff are very approachable and I would speak to the appropriate person’ Staff receive a formal induction training programme and ongoing training. Staff comments about the training provided at Maple Lodge included ‘the service provides training plan for beginners as well as continuous training for existing workers in order to promote and enhance care and protection to service users’ and ‘continuous training - learning all the time’. What has improved since the last inspection? What they could do better: Some areas of medication records still need to improve. For example, there were still some occasions where the balance of medication left from one month is not being carried forward onto the next months medication administration record (MAR) and where the number of ‘as required’ tablets administered was not being recorded. Observation of the lunch time meal and comments made by people living in the home suggest that meal-time service could sometimes be improved. People had to wait for help from staff and there were long delays between the main course and pudding being served. The menu’s (and choice of food) could also be made more accessible to people with dementia with the use of pictures, rather than just written menus. The laundry floor is cracked and worn. Advice should be sought from the environmental health officer to determine if a new, impermeable floor covering is needed to maintain hygiene standards. The fitting of safe door closure systems (which allow doors to be safely left open and automatically shut if the fire alarm sounds) needs to continue and should be completed as soon as Maple Lodge Care Centre DS0000066447.V362046.R01.S.doc Version 5.2 Page 7 possible. Any doors that no longer shut properly due to re-laid carpets, should also be altered as soon as possible. Although the required checks are completed, staff recruitment records should clearly show that all of the required information had been obtained for new staff before they started work in the home. 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. Maple Lodge Care Centre DS0000066447.V362046.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 Maple Lodge Care Centre DS0000066447.V362046.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 People who use the service experience good quality outcomes in this area. Individual needs are assessed before people come to the home, to make sure their needs can be met. Where intermediate care is provided, this is done with the support of the specialist intermediate care team. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: We looked at he care records of four people. These records included assessments of people’s needs. These assessments had been undertaken by the home and by other professionals where this had been appropriate. When we arrived at the home the manager was visiting a local hospital, carrying out assessments on two people who wanted to come and live at the home. Information in the home’s self-assessment told us that Maple Lodge works closely with the local intermediate care team. The home will take people in emergencies for between 2 to 6 weeks, while they receive regular visits from the intermediate care team. This support aims to enable people to regain their independent living skills and return home. Maple Lodge Care Centre DS0000066447.V362046.R01.S.doc Version 5.2 Page 10 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 People who use the service experience good quality outcomes in this area. People’s care records contain up to date information about their needs. People receive the support they need with their personal and health care, in a dignified way. Medication is generally managed in a safe way, although some improvements in recording could be made. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: We looked at the care records of four people. These records included assessments and care plans, which identified people’s needs and how they would be met. The home now used the Four Seasons paperwork and care planning system, which includes monthly evaluations of risk assessments and care plans. This makes sure that the information staff have about people’s needs is kept up to date. The records we inspected identified people’s needs well and observations showed that the care needed was being provided. For example, one person’s care plan said that they needed regular positional changes and records of these taking place were available. The care records we looked at showed that people had regular contact with medical and other professionals. For example, one person had seen the Maple Lodge Care Centre DS0000066447.V362046.R01.S.doc Version 5.2 Page 11 doctor, dietician, optician and chiropodist in the last nine months. The home’s self-assessment told us that each person living at the home is registered with a local doctors surgery. The doctor visits the home weekly and responds to emergency requests. Comments made by people living in the home included ‘I have all the medical support I need as up to now’ and one person told us how they were seeing the chiropodist the next day and had got a new pair of glasses since coming to live at Maple Lodge. Since the last inspection the home has been visited by a CSCI pharmacist. They undertook an inspection, focusing on how the home handles medication. During this inspection we made some random checks on how the home stores, records and administers medication. Improvements appear to have been made since the pharmacists visit, with staff completing training and regular audits being undertaken. There were still some occasions where a balance of medication left from one month was not being carried forward onto the next months medication administration record (MAR) and where the number of ‘as required’ tablets administered was not being recorded. This is important so that there is a clear record of what medication is available and what has been used, to ensure people are getting what they need and for audit purposes. However, in the records inspected these instances were occasional and not regular. On the day of this inspection people looked clean and tidy and staff were seen to interact with people in a friendly way. All eight people living in the home who returned surveys said that they ‘always’ received the care and support they needed. Seven out of eight people said ‘yes’ the staff listened and acted on what they said. Comments made to us by people living in the home included ‘carers are excellent, I like all the staff’, ‘I’m settled, I want to stay here, the staff are lovely’ and ‘I think the care is excellent, the girls are all very kind and I have no complaints whatsoever’. The home’s self-assessment told us that staff are trained to respect people’s privacy and to give people choices. Maple Lodge Care Centre DS0000066447.V362046.R01.S.doc Version 5.2 Page 12 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, 13, 14 & 15 People who use the service experience good quality outcomes in this area. The home’s activities coordinator helps organise individual and group activities on a regular basis. People can have visitors when they want and are asked about their preferences and choices around daily life. Regular meals, drinks and snacks are provided, although some aspects of service and the accessibility of the menu’s could be improved. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: The home has recently appointed a new activities coordinator. On the day of the inspection she was seen doing a number of activities with people, individually and in small groups. For example, in the morning people got hand massages and had their nails and make-up done. In the afternoon she helped a resident pot up plants in the garden. People said how activities had improved recently. Comments made by people living at Maple Lodge included ‘we had a quiz and wine the night before, an entertainer and singers, today they’ve been painting pots to plant seeds in the garden, oh, and I made some cakes the other day, mixed some buns’. The home has ordered a new mini bus to replace the old one, enabling trips out and transport for people when they need it. Money has also been raised to provide a new sensory garden. Maple Lodge Care Centre DS0000066447.V362046.R01.S.doc Version 5.2 Page 13 The home’s self-assessment told us that they have an ‘open door’ visiting policy. People living at the home confirmed that they could have visitors when they liked and that there were no restrictions on visiting. Comments included ‘if I have any visitors they all get asked if they want tea’. Visitors were seen coming and going during the inspection. The self-assessment also says that the home finds out about peoples preferences (for example, preferred bed times and bath times) and this information was included in some people’s care plans. One person commented that ‘they always help me to bath…bathing on a schedule like’, but they also said that they could ask for a bath at other times if they wanted and that they went to bed when they wanted. We spent time observing the lunchtime meal, in both the dementia care and general unit. The dining rooms were pleasant, with the tables set nicely. However, one man in the general dining room had to ask a staff member to bring the sugar to put in his tea, because it and other condiments were not available on the tables for people to help themselves. The day’s menu was available on each table. However, puddings were not included on the menu and it would be good practice to consider using pictures on the menu’s used in the dementia care unit. Pictures of the different foods available could help people with dementia understand and make choices easier than just reading words or answering verbal questions. People had a choice of roast beef and Yorkshire pudding or omelette, served with vegetables and gravy. Desert was rice pudding. One person was served their preferred meal of curry and rice, instead of the main options. The food looked pleasantly presented and with good portion sizes. Staff talked to people during the meal, explained what the food was and tried to encourage people to eat their meal. However, staff seemed busy during the mealtime, with some people waiting quite a while for their meals to be served and for their plates to be cleared away when they had finished. There was also a long wait between the main course and pudding, with people commenting ‘I’m still here’ and ‘did they say there was pudding?’. When this was raised with the manager it was explained that a new admission had arrived early from hospital during lunchtime, so staff had been busy helping settle the new person in, as well as trying to serve lunch to the other residents. However, comments made by people who live in the home about the food included ‘the service could be a bit better, shortage of staff I think because they bring so many up the corridor (meals to people in their own rooms)’, ‘the foods quite good’ and one person said that the food was improving and they now got more variation. The home’s self-assessment told us that people get regular drinks and snacks during the day, including home baked treats and fruit. We observed this happening on the day of the inspection. Maple Lodge Care Centre DS0000066447.V362046.R01.S.doc Version 5.2 Page 14 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 People who use the service experience good quality outcomes in this area. Information is made available to people about making complaints or raising concerns and people feel that they can approach staff if they have a problem. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: There have been no formal complaints or safeguarding issues raised, either directly to CSCI or the home, since the last inspection. The home’s selfassessment told us that people are made aware of the complaints procedure during the admissions process. All eight people living at the home who returned surveys said that they new how to make a complaint. People living in the home said that they could speak to staff if they had any problems, ‘oh yes, I could complain’. One person told us that they felt ‘safe and comfortable’ at Maple Lodge. Comments made by relatives included ‘when I have suggested improvements weve discussed it and it has been acted upon’ and ‘the staff are very approachable and I would speak to the appropriate person’. Staff induction training includes training in the protection of vulnerable adults and the home’s self-assessment told us that staff are encouraged to raise any care issues they are concerned about. Maple Lodge Care Centre DS0000066447.V362046.R01.S.doc Version 5.2 Page 15 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 People who use the service experience good quality outcomes in this area. The home provides a clean and pleasant place for people to live, with work being undertaken to improve the environment where this is needed. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: Maple Lodge was purpose built as a care home in 1991. On the day of the inspection we looked around the home and made observations. The home was clean and tidy and there were no unpleasant smells. People had their own possessions in their bedrooms, which made them homely and pleasant places to spend time. People said they liked the home and that it was clean and tidy. The last inspection highlighted a number of things that needed to be improved, such as the exterior lighting, completing the refurbishment of a bathroom and repairing a fence. This work has now been completed. Since the last inspection work has also been undertaken to improve and update the home. Maple Lodge Care Centre DS0000066447.V362046.R01.S.doc Version 5.2 Page 16 This has included re-decoration, new carpets and new furniture in the lounge, conservatory, activities room, eight bedrooms and the dining room. At the time of the inspection the corridor floors were uneven and could cause people to trip. However, since the inspection the manager has confirmed that the corridor floors have now been levelled and re-carpeted. The home’s exterior woodwork has been repaired, but is still in need of repainting as it looks very worn and untidy. Several people commented on this in their surveys. The manager has confirmed that it will be re-painted in the very near future. All of these issues had already been identified in the home’s selfassessment and plans were in place for the work to be done. This shows that the manager was aware of what needed to be improved and was already taking action. The door into the ‘Willow Wing’ has had a door handle removed from it, leaving a hole in the wooden door. This looks untidy and could be a fire risk, (especially if it is a fire door). The home’s laundry has two washing machines and two tumble driers. The laundry staff confirmed that these work well and that a maintenance contract is in place if anything needs repair. Dissolving laundry bags are used so that staff don’t have to handle soiled laundry and a separate hand washbasin is available. However, the concrete laundry floor looks worn and cracked. Advice from the environmental health officer should be sought to decide if a new, impermeable floor covering is needed to improve hygiene. Maple Lodge Care Centre DS0000066447.V362046.R01.S.doc Version 5.2 Page 17 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, 28, 29 & 30 People who use the service experience good quality outcomes in this area. Staff are employed in sufficient numbers and are provided with the training they need to do their jobs. This judgement has been made using available evidence, including a visit to the service. EVIDENCE: Four people who returned surveys said that staff were ‘always’ available when they needed them. Two people said ‘usually’ and one person said ‘sometimes’. Comments made about staffing levels included ‘If I need them they come’, ‘they always have been (there if needed)’ and ‘more staff could be an improvement, sometimes there arent enough staff in one shift, yet in another shift there are a lot more’. When asked about staffing levels the manager said that they always staff to appropriate levels and that the only time they are short staffed is if someone calls in sick at the last minute and a replacement can not be found. We looked at the home’s staffing rota’s. These showed that the home was usually appropriately and safely staffed, although sometimes the number of staff on duty did vary due to sickness. The home’s self assessment told us that new staff complete an induction programme. The induction records of three new staff were checked and these showed that new staff work through an appropriate induction training programme. All staff who returned surveys said that their induction covered everything they needed to know either ‘very well’ or ‘mostly’. Maple Lodge Care Centre DS0000066447.V362046.R01.S.doc Version 5.2 Page 18 The home’s self assessment told us that staff benefit from an ongoing training programme. Staff comments about the training provided at Maple Lodge included ‘the service provides training plan for beginner as well as continuous training for existing workers in order to promote and enhance care and protection to service users’ and ‘continuous training - learning all the time’. We checked the training that had been given to four staff. These staff had completed a range of training, including important subjects like moving and handling, first aid, food hygiene, infection control and the protection of vulnerable adults. However, the home’s self-assessment shows that less than 50 of the home’s care staff have achieved an national vocational qualification (NVQ) in care. The manager explained that a lot of the home’s workforce are involved with the army and move regularly, making it more difficult to develop a highly qualified workforce. The recruitment records of three staff were inspected. All three of these staff had come to work for the home in the last six months and the home had completed reference checks and criminal records bureaux checks of them. However, some of the start dates recorded in their contracts were before some of the required checks had been completed. The manager explained that this was because people sometimes started their induction training while awaiting for some of the checks to be completed. The manager was reminded of the recent change in the Care Home Regulations and that recruitment records should demonstrate clearly that all of the required information has been obtained about new staff before they start working in the care home. Maple Lodge Care Centre DS0000066447.V362046.R01.S.doc Version 5.2 Page 19 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, 33, 35 & 38 People who use the service experience good quality outcomes in this area. The home is run by an experienced and capable manager. Formal systems are in place to check that the home is being managed appropriately, including people’s finances and health and safety. However, sometimes health and safety related work needs to be prioritised and completed more promptly (such as the fitting of door closure systems and alterations to fire doors). This judgement has been made using available evidence, including a visit to the service. EVIDENCE: The manager of the home is registered with CSCI and has managed the home for four years. She is undertaking the Registered Managers Award (RMA), which is a specialist training course for people who manage care homes. She hopes to have completed the course by August 2008. People living in the home and their relatives felt able to approach staff and the manager to discuss things about their care. A formal quality assurance system is also in place and Maple Lodge Care Centre DS0000066447.V362046.R01.S.doc Version 5.2 Page 20 was described in the home’s self-assessment. This includes a system of audits, checks and surveys that are completed regularly and help to make sure the home is providing people with a good and safe service. We looked at the records of some of these checks during the inspection. The home has in place a policy and procedure setting out how they support people to manage their finances. This has been agreed between Four Seasons and CSCI. A financial assessment is completed, to determine the help people need and how and who will provide it. Individual records of all personal spending are kept, including receipts. These records are regularly checked by the manager and by other people in the organisation. This helps to make sure that people’s money is being used appropriately and people are protected. All residents money is kept in an interest-free, pooled bank account. A cash float is available in the home, so that people can access their money when they want. On the day of this inspection the cash float and recorded balance were checked and found to be correct. There are systems in place to manage health and safety at Maple Lodge. The home employs a maintenance person, who undertakes and records regular maintenance and safety checks. A fire risk assessment of the home was completed in March 2008. The fire officer last visited the home in May 2007 and the three issues identified in his report have since been addressed. Regular checks on fire equipment are carried out and we looked at the records of these checks during the inspection. However, at the time of the inspection it was reported that some fire doors did not shut properly when the fire alarm sounded. The maintenance person explained that this was due to new carpets being fitted and that they were waiting for the company’s joiners to complete the work. Safe door closure systems are in the process of being fitted, where doors need to be propped open, but this work hasn’t yet been completed. Some staff felt that maintenance and repair work like this sometimes took too long for the company to organise and other work taking place in the home at the time of the inspection had taken some time to actually take place. The home’s self assessment told us that maintenance for other equipment is up to date and a random check of maintenance contracts and certificates confirmed this. At the last inspection the safe use of bedrails was raised. Since that inspection the manager has made a number of changes. The use of bedrails is now risk assessed, bedrails are now only used with profiling or hospital beds, padded bumpers are always used, weekly maintenance checks are carried out and people who use bedrails have hourly checks to make sure they are safe. The manager was aware of current good practice guidance on the safe use of bedrails, including that they should only be used as a last resort. However, some of the risk assessments seen during the inspection suggested that the people completing them were not fully aware of the full range of alternatives available (for example, in two assessments the section asking if alternatives Maple Lodge Care Centre DS0000066447.V362046.R01.S.doc Version 5.2 Page 21 had been tried had been completed with ‘what?’ and ‘there are no alternatives’). Maple Lodge Care Centre DS0000066447.V362046.R01.S.doc Version 5.2 Page 22 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 3 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 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Maple Lodge Care Centre DS0000066447.V362046.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 OP9 Good Practice Recommendations Medication in use and in date should be carried over to the next month and the quantity recorded on the new MAR. Where there is a choice in the quantity of medication administered (for example, 1 or 2 tablets as required) the amount given should always be recorded. 2. OP15 The home should consider using pictures on the menus used in the dementia care wing. This could help people understand better what food is on the menu and help them to make more informed choices. The service at meals times should be reviewed, to see how it can be improved (for example, to reduce the time people spend waiting for service or assistance and condiments being made available on the tables for independent use where this is appropriate). Maple Lodge Care Centre DS0000066447.V362046.R01.S.doc Version 5.2 Page 24 3. OP26 Advice should be sought from the environmental health officer to determine if a new, impermeable floor covering for the laundry is needed to maintain hygiene standards. More of the home’s staff should complete an NVQ Level 2 in care. Recruitment records should demonstrate clearly that all of the required information has been obtained about new staff before they start working in the care home. Maintenance jobs that have an impact on health and safety (for example, re-sizing fire doors that no longer shut properly and providing/fitting door closure systems) should always be prioritised and completed as soon as possible. Staff who complete assessments/risk assessments for the use of bedrails should be familiar with current good practice guidance, including the possible alternatives to the use of bedrails. 4. 5. OP28 OP29 6. OP38 Maple Lodge Care Centre DS0000066447.V362046.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Maple Lodge Care Centre DS0000066447.V362046.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. 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!