Inspection on 04/07/07 for Minchenden Lodge

This inspection was carried out on 4th 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

Minchenden Lodge 07/06/06

Minchenden Lodge 31/01/06

Minchenden Lodge 10/10/05

Minchenden Lodge 07/02/05

Minchenden Lodge 04/06/04

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

CARE HOMES FOR OLDER PEOPLE Minchenden Lodge Blagdens Lane Southgate London N14 6DD Lead Inspector Mr David Hastings Key Unannounced Inspection 09:30 4th July 2007 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 Minchenden Lodge DS0000010661.V341522.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. Minchenden Lodge DS0000010661.V341522.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Minchenden Lodge Address Blagdens Lane Southgate London N14 6DD 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) 020 8886 1222 020 8886 1299 Scimitar Care Hotels Plc Ms Maria A Simpkins Care Home 25 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (21) of places Minchenden Lodge DS0000010661.V341522.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th June 2006 Brief Description of the Service: Scimitar Care Hotels PLC owns Minchenden Lodge. The company owns a number of other homes in the North London area. Minchenden Lodge is a long established home in a residential part of Southgate. There is easy access to public transport and shops. The home now has twentyone single rooms and no longer has double rooms. The home is registered to care for twenty-five older people but this is no longer relevant given the new changes to the double rooms. The home has a condition on the registration that allows the home to admit up to four people with a diagnosis of dementia. The home aims to provide personal care only for older people. The aim of the home is to deliver good quality care in comfortable surroundings ensuring that service users needs are met as individually as possible. Fees are between £560 and £600 per week. A weeks respite costs £597. This report is available through the internet. Copies may also be obtained from the provider of this service. Minchenden Lodge DS0000010661.V341522.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 took place on Wednesday 4th July 2007 and lasted six and a half hours. I was assisted throughout the inspection by the registered manager who was open and helpful. I spoke with six staff and nine residents of the home. I inspected the building and examined various care records as well as a number of policies and procedures. All of the residents I spoke with said they were very happy with the care and support they received. One resident told me the staff were, “Pretty marvellous”. What the service does well: What has improved since the last inspection? What they could do better: Two new requirements have been issued as a result of this inspection. Staff must not forget to record the administration of medication and recruitment procedures must be more robust to ensure the safety of residents at the home. Five good practice recommendations have been issued relating to equality and diversity, the recording of review meetings, residents being more involved in their care plans, recording of staff signatures on the medication file and that the manager reviews the access for disabled people in the home. Minchenden Lodge DS0000010661.V341522.R01.S.doc Version 5.2 Page 6 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. Minchenden Lodge DS0000010661.V341522.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Minchenden Lodge DS0000010661.V341522.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 (6 not applicable) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents to the home have good written information available to them about the home. The home carries out satisfactory assessments of individual’s needs so that they know that the home is suitable for them before they decide to move in on a trial basis. EVIDENCE: The home’s statement of purpose and service user guide were examined. These documents gave prospective residents clear information about the service including the home’s aims and objectives. The area manager, who was present on the day of the inspection, told me she had developed a more detailed guide for people moving in to the home which includes frequently asked questions. A good practice recommendation has been issued that the organisation review the service user guide to ensure that it’s statement on equality and diversity outlines how the home will meet the needs of people from different backgrounds and cultures. I looked at three assessments of Minchenden Lodge DS0000010661.V341522.R01.S.doc Version 5.2 Page 9 people who have recently moved into the home. These assessments were detailed and covered all the requirements of Standard 3.3 of the National Minimum Standards for Older People. I spoke with a resident who had recently been admitted to the home who confirmed that the staff understood her needs. The manager told me that most prospective residents visited the home before deciding to move in on a trial period. Although the manager confirmed that residents have a review meeting after about four weeks these meetings are not being recorded. A recommendation has been issued that all initial review meetings with residents and their representatives are recorded. The area manager told me that from now on all prospective residents to the home will be written to confirming that the home has carried out an assessment of their needs and that the home will be able to meet all these assessed needs. Minchenden Lodge DS0000010661.V341522.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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans clearly set out residents’ health, personal and social care needs so that staff know how best to support everyone at the home. Residents have good access to health care professionals and they are treated with respect. Residents get the medication they require, at the right times and by appropriately trained staff. EVIDENCE: Six care plans were examined. These plans were detailed and set out the plan of care for each individual for staff to follow. The plans set out the health, personal and social needs of residents. Care plans gave staff a clear understanding of how people wanted their care to be delivered and included reference to choice, privacy and dignity. Staff I interviewed had a good understanding of the use of care plans and the needs of the people in their care. The manager told me that residents were involved in drawing up their plans and had signed the plan accordingly. Although plans were being reviewed and updated regularly residents did not appear to be involved in the review of Minchenden Lodge DS0000010661.V341522.R01.S.doc Version 5.2 Page 11 their plans. A recommendation has been issued that residents views about the care provided to them are sought and recorded when care plans are reviewed. This will ensure that people have a say in how their care is provided. From records and discussions with the manager it was evident that people have been supported to access health care. The manager confirmed that a general practitioner visits every week and that a dentist and an optician come to the home as and when needed. Residents told me that their health care needs were being met by the home. Throughout the inspection I saw examples of staff treating people with respect and upholding residents’ privacy. For example staff were seen to be knocking on people’s doors before going in. People I spoke with confirmed that they were treated with dignity and staff upheld their need for privacy. Staff I interviewed were able to give practical examples of when they have upheld peoples’ privacy. Records were examined in relation to the receipt, administration and disposal of medication at the home. These records were accurate with one exception. The night before the inspection a member of staff had not recorded the administration of a controlled drug given to a resident. The manager spoke with the member of staff who confirmed that this medication was given and that she had made a mistake in not recording it. The area manager regularly audits medication at the home and all other records were accurate. A requirement has been issued that the administration of all controlled drugs must be accurately recorded. The senior carer confirmed that only staff who have undertaken medication training are able to give out medication. A good practice recommendation has been issued that the names of those staff able to administer medication are recorded in the front of the medication records. Minchenden Lodge DS0000010661.V341522.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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can choose from a range of activities at the home and are kept suitably occupied and engaged. Visitors to the home are made to feel welcome and can visit at any reasonable time. Residents are helped to exercise choice and control over their lives. The food provided is of good quality and mealtimes are relaxed and enjoyable. EVIDENCE: People that I spoke to told me they were happy with the range of activities provided at the home. On the day of the inspection, after lunch, an exercise class was taking place, which residents clearly enjoyed. The majority of people living at the home are able to make their own arrangements for social interaction. Staff were able to give me practical examples of how more dependent residents at the home are kept suitably engaged and occupied. I was impressed that both the manager and staff felt the most important activity was sitting and chatting to people and I saw examples of this throughout the inspection. Residents I spoke with confirmed that visitors to the home are made welcome and tea and coffee was always offered to them. The record of visitors also Minchenden Lodge DS0000010661.V341522.R01.S.doc Version 5.2 Page 13 indicated that residents could have visitors at any reasonable time. I saw a number of visitors to the home during the day of the inspection. One resident told me, “They are good with visitors, very friendly”. Residents confirmed that they were able to have choice and control over their lives at the home. One person said, “You’re not bossed about at all”. Staff I interviewed were able to give examples of how they ensure people are able to exercise choice and control within their daily routines. The kitchen was inspected. The cook on the day of the inspection was aware of individual’s likes and dislikes as well as any special diets people may require. The kitchen was clean and there was a good selection of fresh food. Fridge and freezer temperatures were being monitored and recorded. People I spoke with were very positive about the food provided by the home and confirmed that a choice of menu was always available. One resident told me that the cook was “Marvellous”. Lunchtime was a relaxed and enjoyable experience. Minchenden Lodge DS0000010661.V341522.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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are taken seriously and responded to in a professional manner. Residents are protected from abuse by clear policies and procedures and by an appropriately trained staff team. EVIDENCE: The home has satisfactory policies and procedures in relation to complaints and the protection of residents from abuse. No complaints have been received by the home since the last inspection. All the residents I spoke with said they had no complaints about the service but were clear that they would say something if they had a concern. People were positive about how the manager has responded to any concerns they had. Staff were able to describe to me how vulnerable people could be at risk of abuse in a residential care setting. All staff were clear of their responsibility to report any suspicions of abuse to the appropriate authorities. Residents that I spoke to said they felt safe and well supported at the home. Records indicated that most staff have undertaken training in the protection of vulnerable people. Where staff have not yet received this training I saw evidence that the training had been booked. Minchenden Lodge DS0000010661.V341522.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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is safe and cleaned and maintained to a good standard. EVIDENCE: The manager showed me round the home and I visited some residents in their rooms. The home is clean and decorated to a good standard and has a relaxed atmosphere. Residents that I spoke with said they were happy with their rooms. A good practice recommendation has been issued that the registered manager reviews the access inside and outside the home for people with disabilities. This review should also include the toilets and bathrooms. This should ensure that residents have the aids and adaptations they need. Residents I spoke with said the home was always clean and there were no offensive odours detected throughout the home. A resident told me that the home was, “Spotless”. Records indicated that staff have undertaken training in Minchenden Lodge DS0000010661.V341522.R01.S.doc Version 5.2 Page 16 infection control and there are satisfactory policies and procedures in relation to clinical waste management. On the day of the inspection there were two domestic staff working at the home and the residents praised their hard work in always keeping the home clean. Minchenden Lodge DS0000010661.V341522.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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. All the staff at the home work very hard to meet the needs of residents and are provided with good training opportunities to further enhance their knowledge and skills. Recruitment practices are not sufficiently detailed in order to fully protect residents at the home. EVIDENCE: On the day of the inspection there were twenty residents and four care staff at the home. Residents were very positive about the staff team. One person told me, “ I can’t fault the staff, they are so friendly”. Residents told me that there were enough staff on duty to meet their needs. The rota was examined and matched the names of the staff working that day. Staff told me they were happy working at the home and staff turnover is low. This benefits residents and ensures a consistent approach to care provision. The area manager informed me that the organisation was developing a system to provide bank staff at the home to cover annual leave and sickness. I was able to meet with the training, development and safety manager who was visiting the home on the day of the inspection. Records indicated that over 50 of care workers have now completed NVQ level 2 or equivalent. Minchenden Lodge DS0000010661.V341522.R01.S.doc Version 5.2 Page 18 Staff were very positive about the training offered to them and the training manager was able to show me individual staff training profiles which indicated that staff at the home receive the training required to do their jobs effectively. The training manager is to be commended for ensuring staff receive the training they need. I examined three staffing files from staff recently employed at the home. Some of the references obtained for staff did not have a company stamp or letter headed paper enclosed to prove the identity of the referee. A requirement has been issued relating to this matter in the relevant section of this report. The area manager told me she was aware of this issue and will be reviewing the organisations recruitment procedures. It is very important that staff recruitment procedures are sufficiently thorough to ensure the protection of residents. Minchenden Lodge DS0000010661.V341522.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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager of the home knows the residents very well and understands their needs. Residents do have opportunities to have a say in how the home is run. Residents’ financial interests are being safeguarded. The health and safety of residents and staff are promoted and protected. EVIDENCE: The manager has recently completed the NVQ registered managers award and a requirement, issued at the last inspection relating to this has now been complied with. Both staff and residents were very positive about the manager. One staff member told me that the manager was, “Firm but fair”. A resident Minchenden Lodge DS0000010661.V341522.R01.S.doc Version 5.2 Page 20 told me that the manager is, “Fantastic” another told me that she is, “Very kind”. Quality monitoring questionnaires have been sent out to residents and they confirmed that they had received them. The area manager said that the results of these surveys would be published shortly. The home does not usually hold money on behalf of residents. If residents need anything the manager told me that this is purchased by the home and a monthly bill is sent to the resident or their representative. Some minor items such as toiletries are available to buy at the home. A price list is provided to residents so that they know the cost of each item they may wish to buy. Satisfactory records were seen in relation to fire prevention. Staff undertake fire drills on a regular basis. Records indicated that staff are undertaking the required health and safety training. Other records seen in relation to electrical installation, gas safety, Legionnaires, PAT testing and maintenance of equipment at the home were all satisfactory. Minchenden Lodge DS0000010661.V341522.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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Minchenden Lodge DS0000010661.V341522.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 OP9 Regulation 13(2) Requirement Timescale for action 01/08/07 2. OP29 19(1) c The registered person must ensure that the administration of all controlled drugs at the home is accurately recorded. The registered person must 01/08/07 ensure that all written references received contain either a company stamp or a printed letterhead enclosed to confirm the authenticity of the reference. 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 OP1 Good Practice Recommendations The registered person should review the service user guide to ensure that it’s statement on equality and diversity outlines how the home will meet the needs of people from different backgrounds and cultures. The registered person should ensure that all initial review meetings that take place after four to six weeks of the person moving into the home are recorded. DS0000010661.V341522.R01.S.doc Version 5.2 Page 23 2. OP6 Minchenden Lodge 3. 4. 5. OP7 OP9 OP19 The registered person should ensure that the views of residents are sought every time care plans are reviewed. The registered person should ensure that the names of staff, along with their signature are recorded on the medication administration file. The registered manager should review the access inside and outside the home for people with disabilities. This review should also include the toilets and bathrooms. Minchenden Lodge DS0000010661.V341522.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Harrow Area Office 4th Floor, Aspect Gate 166 College Road Harrow London HA1 1BH 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 - 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. 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