Inspection on 11/07/07 for Mill Lodge Care Home

This inspection was carried out on 11th July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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

Mill Lodge Care Home 30/09/09

Mill Lodge Care Home 23/03/06

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Mill Lodge Care Home Belmont Road Great Harwood Lancashire BB6 7HL Lead Inspector Mr Graham Oldham Unannounced Inspection 11th July 2007 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 Mill Lodge Care Home DS0000066089.V338719.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. Mill Lodge Care Home DS0000066089.V338719.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mill Lodge Care Home Address Belmont Road Great Harwood Lancashire BB6 7HL 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) 01254 883216 Mr Karamchand Jhugroo Mrs Pryamvada Jhugroo Mrs Pryamvada Jhugroo Care Home 16 Category(ies) of Dementia - over 65 years of age (16), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (3), Old age, not falling within any other category (6) Mill Lodge Care Home DS0000066089.V338719.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 16 service users to include: Up to 16 service users in the category of DE(E) (dementia over 65 years of age) requiring personal care. Up to 6 service users in the category of OP (over 65 years of age, not falling into any other category) requiring personal care. Up to 3 service users in the category of MD(E) (mental disorder, excluding learning disability or dementia over 65 years of age) requiring personal care. When any of the service users in the category of MD(E) leave the care home, the registered person must apply for a variation to have maximum numbers of 3 reduced accordingly. The care home should employ a suitably qualified and experienced manager, who is registered with the Commission for Social Care Inspection. 22nd August 2006 2. 3. Date of last inspection Brief Description of the Service: Mill Lodge is situated within walking distance of the town centre of Great Harwood. There are 14 single bedrooms and one double bedroom situated on two floors. Access to the first floor is via a passenger lift. Communal space consists of a separate lounge and a dining room that leads to a furnished conservatory. Some internal areas are ramped. Toilets and baths are located near to communal rooms and bedrooms. Residents have access to all community health services, and activities and functions are available to everyone living at the home. A statement of purpose and service users guide is available for residents or their families to be informed of the facilities and services the home provides. The documents need updating to inform prospective residents of the change of ownership. The fees for Mill Lodge are £352.50 - £374.50 per week. Not included within the fees are hairdressing, newspapers or periodicals and outings. Mill Lodge Care Home DS0000066089.V338719.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection, which included a visit to the home, took place on the 11th July 2007. Much of the information gained was obtained from talking to management and staff members. The views of residents could not be obtained in any depth. Residents were observed in the lounge and throughout the day and their interaction with staff. People living within the home allowed the inspector to call them residents. Two residents were case tracked. Case tracking gave the inspector an overall view of the specific care for the individual resident by checking their plans of care, other documentation and talking to staff about the care they gave each resident case tracked. Two staff members were questioned about the care of the residents case tracked and the training they had undertaken. Some of the views have been reported collectively with specific comments contained within the body of the report. The inspector took detailed notes during the inspection, which have been retained as evidence. Staff were directly and indirectly observed carrying out their tasks and interacting with residents. Paperwork examined included plans of care, assessment documentation, policies and procedures or documents relevant to each standard. A tour of the building was conducted on the day of the inspection. What the service does well: The assessment of residents prior to admission ensured the home could meet the needs of residents. Plans of care contained sufiicient detail for staff to deliver effective care. Residents were provided with suitable activities to help residents lead a more stimulating life. The food served at the home was suitable to residents needs and met their nutritional needs. Mill Lodge Care Home DS0000066089.V338719.R01.S.doc Version 5.2 Page 6 Staff were careful to protect the residents privacy and dignity to allow them to feel comfortable with their personal care. Visiting was open and unrestricted to ensure residents were able to interact with their families and friends. Robust recruitment procedures helped protect residents from possible abuse. One resident case tracked said, “The food is good. I live here – it’s nice and I am very well”. Residents in general appeared calm and happy with the care and treatment they received. What has improved since the last inspection? The statement of purpose and service user guide had been amended to inform residents or professionals of the facilities and services the care home provided. Residents were issued with a contract which explained the terms and conditions for living at Mill Lodge. Following assessment residents were informed their needs could be met at the home and satisfy residents and their families they were correctly placed. Plans of care had been reviewed on a regular basis to ensure staff were up to date about a residents needs. Medication policies and procedures had been reviewed in line with the Royal Pharmaceutical guidelines to ensure current practice was safe. Gas and electrical appliances and installation had been undertaken to protect the health and welfare of residents. The registered manager had achieved NVQ4 qualifications and updated her knowledge in several areas to provide a better service for residents. Several areas of the home had been refurbished or decorated to provide a more comfortable environment for residents. A fire risk assessment had been undertaken and work was being undertaken to further protect the health and welfare of residents. Mill Lodge Care Home DS0000066089.V338719.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Mill Lodge Care Home DS0000066089.V338719.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 Mill Lodge Care Home DS0000066089.V338719.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): OP1, OP2, OP3 and OP4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The statement of purpose and service user guide informed residents and their families of the services and facilities which were provided. The assessment process enabled staff to plan and deliver effective care to residents. Each resident was issued with a terms and conditions document and received confirmation their needs could be met at the care home. EVIDENCE: The statement of purpose and service user guide had been updated to include the names of the responsible individual and registered manager to ensure residents, their families and professionals were kept up to date with information about the care service. There was a contract document which explained the terms and conditions for staying at Mill Lodge. Relatives had signed their agreement to the terms and conditions. Contained within the contract was written confirmation, following assessment, the needs of residents could be met at the care service. Residents Mill Lodge Care Home DS0000066089.V338719.R01.S.doc Version 5.2 Page 10 and their families were aware of their rights and satisfied management had assessed their needs prior to admission. Two residents were case tracked. Plans of care contained assessment documentation. A suitably experienced staff member had assessed each resident prior to admission. Social Services had assessed residents as suitable to be placed at the home. The good assessment ensured the service could meet the diverse needs of residents. Mill Lodge Care Home DS0000066089.V338719.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): OP7, OP8, OP9 and OP10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Plans of care and health care assessments contained sufficient information to inform staff of each residents needs. Medication policies, procedures and staff training protected the health and welfare of residents. The attitude and practice of staff protected the privacy and dignity of residents. EVIDENCE: Two plans of care were examined during the case tracking process. Plans of care generally contained up to date and accurate information about a residents needs. The manager was advised to conduct an audit to ensure the one or two gaps in monthly assessments were addressed. Plans of care had been developed with the assistance of family members or residents. Plans of care contained sufficient information for staff to read and deliver effective care. Resident’s case tracked had been risk assessed for falling, nutritional and pressure area needs. The risk assessments should provide better information for staff to follow and minimise risks. Evidence was obtained from the plans of Mill Lodge Care Home DS0000066089.V338719.R01.S.doc Version 5.2 Page 12 care that residents had access to specialists and professionals. Residents had access to specialists to ensure their changing health care needs were met. Trained staff administered medication. Policies and procedures for the administration of medication had been reviewed using the Royal Pharmaceutical Societies Guidelines. There was a controlled drug cupboard and register. There was a fridge to keep medication cool. The medication administration charts had been maintained accurately. Medication policies, procedures and staff training helped reduce the risk of any medication errors. Staff were observed carrying out personal care to residents. Staff were pleasant to residents and ensured their privacy was maintained when delivering care. The good attitude of staff ensured residents were comfortable with the personal care they received. Mill Lodge Care Home DS0000066089.V338719.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): OP12, OP13, OP14 and OP15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Leisure activities provided were suitable to resident’s tastes and helped provide a fulfilling life. Visiting was open, unrestrictive and encouraged socialising with family and friends. Staff offered choice to residents, which helped them retain some control over their lives. Food served at the home met residents nutritional needs. EVIDENCE: Residents and staff were observed interacting several times during the day. A good rapport existed between staff and residents. Residents appeared happy and joined in games such as patting a balloon around or listened to music. Residents interacted with each other and some had obviously made friends. Residents were offered a choice at mealtimes. Staff questioned gave choice of clothes, choice of getting up or going to bed and how residents were able to access all parts of the home as how they helped residents retain their independence. Residents were offered choices to help minimise their debilitating condition and help provide a happy atmosphere. The kitchen was clean and tidy and the cook completed all necessary environmental health checks. There was a record of meals taken. The Environmental Health department had lately inspected the home and had Mill Lodge Care Home DS0000066089.V338719.R01.S.doc Version 5.2 Page 14 made some recommendations. Some of the recommendations had been completed and the rest planned. The meal served on the day of the inspection was nutritionally balanced and appeared tasteful. Residents were observed eating and enjoying the meal. Residents were able to say the meal was good. Residents were fed in a discreet manner and assistance was offered to all residents in the dining room if they required it. There was a set menu and the meal being served was put on a notice board on a daily basis. Residents were satisfied with the food served at Mill Lodge. The leisure activities were recorded in an activities book. The deputy manager said, “A typical week for activities includes exercises with balloons, dominoes, picture millionaire, bingo and music and movement. One resident goes out with an outside agency. Some residents go out with their families. Staff take residents to park and shops if the weather is good”. On the day of the inspection the residents were either listening to music, watching television and in the afternoon were playing games. Residents were allowed to roam freely. Residents were offered activities to help them live a more fulfilling life. Although no visitors were observed on the day of the inspection the daily records showed residents were able to receive visitors and visiting was encouraged for the benefit of residents. Mill Lodge Care Home DS0000066089.V338719.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): OP16 and OP18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Policies, procedures and staff training helped protect residents from harm and abuse. Residents and their families were able to voice their concerns. EVIDENCE: There was a complaints procedure, which meets current guidelines. There had been one complaint made to the Commission for Social Care Inspection (CSCI) since the last inspection. The complaint was investigated by the service and using the evidence provided was not substantiated. The issues raised were followed up at inspection and no concerns were found. The registered manager said no complaints had been made to the service. Two staff spoken to were aware of the complaints procedure. The complaints procedure was available for residents or their families to bring their concerns to the care service or the CSCI. There were policies and procedures for the protection of vulnerable adults. The service used the Lancashire County Council adult abuse procedures to follow a local initiative. The manager said no allegations of abuse had been made since the last inspection. There was a copy of the ‘NO Secrets’ document and a whistle blowing policy. Two staff members questioned were aware of abuse issues. Residents were protected from possible abuse. Mill Lodge Care Home DS0000066089.V338719.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): OP19 – OP26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents lived in a clean, tidy and safe environment. The facilities provided a comfortable setting and met resident’s environmental needs. EVIDENCE: The home was warm, clean and free from offensive odours. The lounges and dining room contained good furnishings and were domestic in character. The décor was homely and there were plans to improve the home further. Bedrooms had been personalised to resident’s tastes and contained a reasonable amount of equipment. A tour of the building was conducted during the inspection. There was a plan of maintenance and a development plan. Several areas of the home had been upgraded and this included new carpets and moving the ramp to the lounge so all residents could be sat in the room to attend social events and leisure activities if they wished. Baths were assisted and corridors had grab rails. There was a passenger lift and chair lifts for residents to access all areas. Lighting was sufficient to meet the needs of residents. The garden was accessible to the disabled and furniture was Mill Lodge Care Home DS0000066089.V338719.R01.S.doc Version 5.2 Page 17 available for residents to use in good weather. Windows had been fitted with suitable restricting devices and radiators were guarded for the protection of residents. Several water outlets were tested to check the temperature of water. One bath did not appear to have a controlling device fitted and posed a serious threat to the health and safety of residents. The homely atmosphere provided satisfactory living space for residents. There were infection control policies for staff to follow and deliver safe practice. The laundry contained equipment suitable to provide a good service to residents. The walls and floors could be cleaned and maintained. Hand washing facilities and paper towels were available where clinical waste was produced. Infection control policies and procedures protected the health and welfare of residents. Mill Lodge Care Home DS0000066089.V338719.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): OP27, OP28, OP29 and OP30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were sufficient numbers of qualified and experienced staff to meet the needs of residents. The recruitment procedures protected residents from possible abuse. EVIDENCE: The staffing rota showed there were sufficient numbers of staff on duty on the day of the inspection. More than 90 of staff had completed NVQ2 or 3 training. Staff received recognised induction training. Two staff files demonstrated training was ongoing. Both staff members involved in the inspection process confirmed sufficient training was offered and they were encouraged to improve. There were sufficient numbers of well-trained staff to care for the vulnerable group of residents accommodated at the care home. Two staff files examined during the inspection demonstrated the recruitment procedures were robust and ensured staff were fit to be employed at the care service. Mill Lodge Care Home DS0000066089.V338719.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): OP31, OP33, OP35 and OP38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The views of residents, staff and stakeholders had been obtained to assist the manager to react to the changing needs of residents. There was a safe system to protect residents from possible financial abuse. Health and safety policies, procedures, staff training and the regular maintenance of equipment helped protect the health and welfare of residents and staff. EVIDENCE: The registered manager was a qualified nurse with many years experience catering for the resident group accommodated at the home. The registered manager had completed NVQ4 training. The registered manager was advised to add her hours she worked to the off duty to demonstrate her full time commitment. She had taken training for health and safety, fire awareness, moving and handling, continence care and basic food hygiene since the last Mill Lodge Care Home DS0000066089.V338719.R01.S.doc Version 5.2 Page 20 inspection to update her knowledge. The registered manager continued to update her knowledge for the benefit of residents and staff The systems used handle any residents finances were safe and protected residents from possible financial abuse. The manager held recorded meetings with staff and said she talked to family members to help improve the service. There was a business plan. Quality assurance questionnaires had been completed by some of the people involved at the home and demonstrated the service responded to the changing needs of those connected with the home. There was a health and safety policy. Staff spoken to said they had undertaken health and safety related training. Electrical and gas appliances and installation had been maintained to a good level. Fire alarms and other safety related equipment had been maintained. Health and safety policies, procedures and staff training helped protect the health and welfare of residents. Mill Lodge Care Home DS0000066089.V338719.R01.S.doc Version 5.2 Page 21 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 3 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 2 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Mill Lodge Care Home DS0000066089.V338719.R01.S.doc Version 5.2 Page 22 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. 1. Standard OP25 Regulation 13(4)(a) Requirement The registered manager must ensure all parts of the home are free from hazards to resident’s safety. Hot water outlets in baths must have a suitable device fitted to restrict the temperature to restrict the risk of scalding.. Timescale for action 30/07/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP8 Good Practice Recommendations The registered manager should ensure the risks identified and the desired outcomes are clearly written in sufficient detail to allow staff to have the information to protect residents. The registered manager should ensure the hours she works are recorded on the rota sheet. The registered manager should ensure the views gained from questionnaires are produced in a summary and are available for inspection. 2. 3. OP31 OP33 Mill Lodge Care Home DS0000066089.V338719.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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 Mill Lodge Care Home DS0000066089.V338719.R01.S.doc Version 5.2 Page 24 - 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!